Intra-operative tumour localisation in robot-assisted minimally invasive surgery: A review

Abstract

Robot-assisted minimally invasive surgery has many advantages compared to conventional open surgery and also certain drawbacks: it causes less operative trauma and faster recovery times but does not allow for direct tumour palpation as is the case in open surgery. This article reviews state-of-the-art intra-operative tumour localisation methods used in robot-assisted minimally invasive surgery and in particular methods that employ force-based sensing, tactile-based sensing, and medical imaging techniques. The limitations and challenges of these methods are discussed and future research directions are proposed.

Ex vivo study of prostate cancer localization using rolling mechanical imaging towards minimally invasive surgery

“…6, we demonstrate a case where a patient had a tumor detectable by RMI and pathology but this lesion was invisible on MRI. As mentioned in the introduction section, MRI is useful for predicting tumor size of cancer foci greater than 10 mm in diameter [4]. Due to the higher resolution (the positional 14 resolution of the Phantom OmniTM is 0.055mm; the force resolution is 0.003N; and, the scanning resolution is ±0.5mm), the probe is sensitive to the existence of a small tumor buried near the surface of the organ.…”

“…However, robotic surgery throws down a new challenge, because it deprives surgeons of haptic feedback and therefore tissue stiffness assessment afforded by their fingers or dissection instruments. Therefore, dissection planes and in particular, bladder neck sparing or nerve sparing increments can be decided only by pre-operative assessments about tumor stage and visual cues [4]. 4 It is possible that the loss of haptic feedback is one reason why robotic surgery has failed to deliver convincingly (at least to date) significant improvements in functional outcomes relative to open or conventional laparoscopic surgery.…”

“…Therefore, dissection planes and in particular, bladder neck sparing or nerve sparing increments can be decided only by pre-operative assessments about tumor stage and visual cues [4]. 4 It is possible that the loss of haptic feedback is one reason why robotic surgery has failed to deliver convincingly (at least to date) significant improvements in functional outcomes relative to open or conventional laparoscopic surgery. Furthermore, given tumor localization is critical to surgical precision and ultimately patient outcomes, new techniques to replace the loss of haptic feedback are paramount.…”

A review on recent advances in soft surgical robots for endoscopic applications

“…Several articles have reviewed the medical robotics for MIS applications (eg,) most of which are outdated. Moreover, a few studies reviewed the recent developments in soft robotics actuators and sensors .…”

“…2 By manipulating either intrinsic Young modulus or actuating a pair of antagonistic actuator of soft robots in different ways, stiffness of the soft robots can also be tuned. 3 Several articles have reviewed the medical robotics for MIS applications (eg, [4][5][6][7][8][9][10][11][12] ) most of which are outdated. Moreover, a few studies reviewed the recent developments in soft robotics actuators and sensors.…”